| NPI | 1013295179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: TN 51170) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA08809000) |
| Enumeration Date | 2011-07-23 |
| Last Update Date | 2014-09-06 |