| NPI | 1932555927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MB10398800) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MB10398880) |
| Enumeration Date | 2016-05-09 |
| Last Update Date | 2023-08-21 |