| NPI | 1427419761 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MB10867800) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP03610) |
| Enumeration Date | 2016-03-15 |
| Last Update Date | 2021-12-14 |