| NPI | 1952920761 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 328055) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI03786200) |
| Enumeration Date | 2020-04-11 |
| Last Update Date | 2024-05-17 |