| NPI | 1659573525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MB08035500) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OS012822) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2024-08-28 |