| NPI | 1730520073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MB09784500) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0102204392) |
| 207R00000X Internal Medicine (Licence: NY 286243) | |
| Enumeration Date | 2013-07-15 |
| Last Update Date | 2018-03-17 |