| NPI | 1942736475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 1942736475) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA10778600) |
| Enumeration Date | 2017-05-03 |
| Last Update Date | 2024-01-24 |