| NPI | 1497121743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA10445600) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA10445600) |
| 207R00000X Internal Medicine (Licence: CT 61943) | |
| Enumeration Date | 2015-08-20 |
| Last Update Date | 2022-01-11 |