| NPI | 1891116729 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD452833) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA09482000) |
| 207RN0300X Internal Medicine, Nephrology (Licence: PA MD452833) | |
| Enumeration Date | 2013-12-19 |
| Last Update Date | 2023-01-03 |