| NPI | 1770502221 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD429251) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NJ 25MA10750900) |
| 207R00000X Internal Medicine (Licence: NC 2009-00801) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2021-11-22 |