| NPI | 1437302692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A125934) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA08661500) |
| 207R00000X Internal Medicine (Licence: NY 257623) | |
| Enumeration Date | 2008-10-30 |
| Last Update Date | 2022-10-11 |