| NPI | 1285648972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: NJ MA40219) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ MA40219) |
| 207RG0300X Internal Medicine Geriatric Medicine (Licence: NJ MA40219) | |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2008-01-23 |