| NPI | 1083688857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD041728L) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ 25MA05325300) |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2019-02-19 |