| NPI | 1962829127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NJ 25MA10879800) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA10879800) |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2023-08-14 |