| NPI | 1023337698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CO DR.0057253) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MB09323200) |
| 207R00000X Internal Medicine (Licence: CO DR.0057253) | |
| Enumeration Date | 2010-05-21 |
| Last Update Date | 2016-08-02 |