| NPI | 1275562811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: NJ 25MA03564300) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA03564300) |
| 207UN0901X Nuclear Medicine Nuclear Cardiology (Licence: NJ 29-28684-02) | |
| 207UN0902X Nuclear Medicine Nuclear Imaging & Therapy (Licence: NJ 29-28684-02) | |
| 261QP2300X Clinic/Center Primary Care (Licence: NJ 25MA03564300) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2025-04-16 |