| NPI | 1891974507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 2458951) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 245895) |
| 207R00000X Internal Medicine (Licence: NJ 25MA08308000) | |
| Enumeration Date | 2007-10-30 |
| Last Update Date | 2024-03-26 |