| NPI | 1841290723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 228483) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA12165500) |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2024-09-27 |