| NPI | 1588302293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA13146000) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2024-03611) |
| Enumeration Date | 2022-05-23 |
| Last Update Date | 2026-07-28 |