| NPI | 1922087188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD442909) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 221271 Limited) |
| 207R00000X Internal Medicine (Licence: NJ 25MA08978100) | |
| Enumeration Date | 2006-01-15 |
| Last Update Date | 2014-08-21 |