| NPI | 1376806315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA10646900) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 02004661A) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 276131) | |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2020-03-03 |