| NPI | 1942734173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MB12239400) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OS019523) |
| 207R00000X Internal Medicine (Licence: PA OT017547) | |
| Enumeration Date | 2017-04-13 |
| Last Update Date | 2024-11-12 |