| NPI | 1902898596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE C1-0027237) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA07176500) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NJ MA071765) | |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2024-08-23 |