| NPI | 1336258334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA OS004481L) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ MB37784) |
| 207R00000X Internal Medicine (Licence: PA OS004481L) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2017-01-17 |