| NPI | 1619156445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 24933) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ MA51880) |
| Enumeration Date | 2007-10-29 |
| Last Update Date | 2024-08-01 |