| NPI | 1619969623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: NJ 66554) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 66554) |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2007-07-12 |