| NPI | 1447548052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA09522900) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD468223) |
| Enumeration Date | 2011-07-17 |
| Last Update Date | 2022-08-01 |