| NPI | 1609266428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD473523) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD473523) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NJ 25MA11455300) | |
| Enumeration Date | 2015-02-01 |
| Last Update Date | 2022-11-23 |