| NPI | 1376717694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WV 24018) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA08297600) |
| Enumeration Date | 2008-04-17 |
| Last Update Date | 2011-10-31 |