| NPI | 1942529052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA OS018837) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MB09243400) |
| Enumeration Date | 2010-05-28 |
| Last Update Date | 2025-09-23 |