| NPI | 1528089612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD031348E) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA04169400) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2019-12-05 |