| NPI | 1831154426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA09970300) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 46544020) |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2022-12-01 |