| NPI | 1215033030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NJ 25MA08634600) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NH RT-1467) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2019-01-28 |