| NPI | 1538690946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA11997400) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD475518) |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2024-05-03 |