| NPI | 1275550915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NJ 25MA06398600) |
| Additional Taxonomies | 207RA0000X Internal Medicine, Adolescent Medicine (Licence: NJ 25MA06398600) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2012-08-28 |