| NPI | 1992776777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA11696000) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 227338) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2025-07-31 |