| NPI | 1952794489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA10987900) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: NY 311394) |
| 207R00000X Internal Medicine (Licence: NY 311394) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NY 311394) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NY p96373) | |
| 207Q00000X Family Medicine (Licence: NY 311394) | |
| Enumeration Date | 2015-03-09 |
| Last Update Date | 2024-01-03 |