| NPI | 1861966178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA12831900) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY P12405) |
| Enumeration Date | 2019-01-20 |
| Last Update Date | 2025-11-10 |