| NPI | 1679936637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA10771700) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NJ 25ma10771700) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NJ 25ma10771700) | |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2026-03-26 |