| NPI | 1568532547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 217580) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA10470600) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2021-05-14 |