| NPI | 1598023996 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NJ 25MB09853300) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MB09853300) |
| 207R00000X Internal Medicine (Licence: PA OSO17426) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2016-07-21 |