| NPI | 1659457265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NJ 25MA05287000) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ MA52870) |
| 207R00000X Internal Medicine (Licence: NJ 25MA05287000) | |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2012-12-31 |