| NPI | 1689676421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA07594400) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DE C1-0026372) |
| 207R00000X Internal Medicine (Licence: NC 90600250) | |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2023-11-14 |