| NPI | 1437177615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA06521900) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2018-02759) |
| 207R00000X Internal Medicine (Licence: FL ME138440) | |
| 207R00000X Internal Medicine (Licence: GA 081925) | |
| 207R00000X Internal Medicine (Licence: CA C162185) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2019-12-10 |