| NPI | 1962652735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA09419200) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D86650) |
| 207R00000X Internal Medicine (Licence: KY 49790) | |
| Enumeration Date | 2008-09-29 |
| Last Update Date | 2024-06-03 |