| NPI | 1306332127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NJ 25MA12423500) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 174267) |
| Enumeration Date | 2018-07-04 |
| Last Update Date | 2025-06-16 |