| NPI | 1750644704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: PA OS019131) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NJ 25MB09686600) |
| 207R00000X Internal Medicine (Licence: NJ 25MB09686600) | |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2025-10-21 |