| NPI | 1437202017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA05562400) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 76723) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2025-09-04 |