| NPI | 1942244405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD431016) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA08035100) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2012-09-27 |