| NPI | 1952604464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME154659) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA09296200) |
| Enumeration Date | 2010-12-06 |
| Last Update Date | 2024-02-15 |