| NPI | 1679823645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME153235) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA09752600) |
| 207RP1001X Internal Medicine Pulmonary Disease (Licence: NJ 25MA09752600) | |
| Enumeration Date | 2012-09-17 |
| Last Update Date | 2022-08-19 |