| NPI | 1285049171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NJ 25MA11505600) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.131017) |
| 207R00000X Internal Medicine (Licence: NY 301042-01) | |
| 207R00000X Internal Medicine (Licence: PA MD472047) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2022-08-19 |