| NPI | 1942695853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301115458) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA09902100) |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2023-07-04 |