| NPI | 1629047709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101262663) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 225612) |
| 207R00000X Internal Medicine (Licence: NJ 25MA07687800) | |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2023-01-20 |