| NPI | 1811159593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA09038600) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA md435133) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2025-08-12 |