| NPI | 1902193311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NJ 25MA09912100) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT199222) |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2016-08-09 |