| NPI | 1871087502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NJ 25MA12581100) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 286469) |
| Enumeration Date | 2018-06-16 |
| Last Update Date | 2025-08-04 |