| NPI | 1649699034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NJ 25MA11129700) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301105299) |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2021-10-08 |