NPI | 1194086041 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NJ 25MA12053900) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 251885) |
207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD466806) | |
Enumeration Date | 2012-06-06 |
Last Update Date | 2024-08-28 |