| NPI | 1164603965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX N5778) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA08260900) |
| Enumeration Date | 2007-11-20 |
| Last Update Date | 2021-06-25 |