| NPI | 1386637833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NJ 25MA08749100) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: UT 5123441205) |
| Enumeration Date | 2005-08-30 |
| Last Update Date | 2017-10-03 |