| NPI | 1679928584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA10526000) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: NJ 25MA10526000) |
| 207RI0011X Internal Medicine Interventional Cardiology (Licence: NJ 25MA10526000) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: 244202) | |
| Enumeration Date | 2016-04-28 |
| Last Update Date | 2025-07-14 |