| NPI | 1619147410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NJ 25MA07675900) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA07675900) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD-041616-L) | |
| Enumeration Date | 2008-03-07 |
| Last Update Date | 2022-09-07 |