| NPI | 1720775737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE C2-0025017) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MB12946500) |
| Enumeration Date | 2023-04-19 |
| Last Update Date | 2026-07-31 |