| NPI | 1972985448 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 298498) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA12009700) |
| 207R00000X Internal Medicine (Licence: PA MD464916) | |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2024-06-17 |