| NPI | 1073976411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NJ 25MA11725300) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.135697) |
| 207R00000X Internal Medicine (Licence: MI 4301501780) | |
| Enumeration Date | 2016-04-02 |
| Last Update Date | 2024-01-02 |