| NPI | 1760484729 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NJ MA052652) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: NJ MA052652) |
| Enumeration Date | 2005-06-02 |
| Last Update Date | 2008-09-09 |