| NPI | 1699006445 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NJ 25MA09609200) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA09609200) | 
| 207UN0901X Nuclear Medicine, Nuclear Cardiology (Licence: NJ 25MA09609200) | |
| Enumeration Date | 2010-01-19 | 
| Last Update Date | 2025-01-08 |