| NPI | 1952322836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: UT 7967325-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA07930400) |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2022-06-09 |