| NPI | 1689025223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: NJ 25MA10822300) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD468499) |
| Enumeration Date | 2016-06-24 |
| Last Update Date | 2025-07-31 |