| NPI | 1548656556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA11780600) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 294573-01) |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2023-08-14 |