| NPI | 1780882464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 261010) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD431956) |
| 207R00000X Internal Medicine (Licence: NJ 25MA08715900) | |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2024-09-01 |