| NPI | 1710977426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA04030600) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD024381E) |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2018-02-22 |