| NPI | 1457369233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA OS007761L) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MB10523400) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2022-11-09 |