| NPI | 1578777439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA08177400) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 249580) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2026-07-29 |