| NPI | 1538784178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA OS021734) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MB12017000) |
| 207R00000X Internal Medicine (Licence: NY 321353) | |
| Enumeration Date | 2020-06-09 |
| Last Update Date | 2024-08-08 |