| NPI | 1396765095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AL DO.1143) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MB07842300) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NJ 25MB07842300) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2022-11-30 |