| NPI | 1902335565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25IA12289500) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D008871) |
| Enumeration Date | 2017-06-07 |
| Last Update Date | 2024-08-21 |