| NPI | 1063606101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME127308) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NJ 25MA08279500) |
| Enumeration Date | 2007-08-31 |
| Last Update Date | 2017-01-20 |