| NPI | 1356363352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: NJ 25MA05034600) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA05034600) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2011-10-18 |