| NPI | 1366674889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204R00000X Electrodiagnostic Medicine (Licence: NJ 25MA09691700) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NJ 25MA09691700) |
| Enumeration Date | 2009-08-17 |
| Last Update Date | 2017-02-28 |