| NPI | 1124053681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: NJ 25MB03351700) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: PA OS003661L) |
| 207RC0000X Internal Medicine Cardiovascular Disease (Licence: AZ 3639) | |
| 207RC0000X Internal Medicine Cardiovascular Disease (Licence: NY 200056) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2014-06-09 |