| NPI | 1669835641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA10615500) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME148925) |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2025-08-26 |