| NPI | 1659419174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: IL 036168830) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 225100000X Physical Therapist (Licence: NJ 028857-1) | |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2024-09-19 |