| NPI | 1649684556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NJ 25MA11060200) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT207468) |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2021-07-02 |