| NPI | 1013127299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: NJ 25MA11853900) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: NC 2017-00462) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2024-12-03 |