| NPI | 1619230307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MB09647300) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OS022983) |
| 207R00000X Internal Medicine (Licence: MD H0098527) | |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2024-01-09 |