| NPI | 1780664847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD019409E) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ MA03326900) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NJ MA03326900) | |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2017-03-21 |