| NPI | 1740423771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.142049) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA09307000) |
| 207R00000X Internal Medicine (Licence: PA MD446945) | |
| Enumeration Date | 2009-04-06 |
| Last Update Date | 2022-02-07 |