| NPI | 1457477853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101271170) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ MA07310800) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2022-12-05 |