| NPI | 1699331256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NJ 25MA12594900) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 326958) |
| Enumeration Date | 2019-05-19 |
| Last Update Date | 2025-05-09 |