| NPI | 1790907673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: PA MD422223) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: NJ 25MA08662000) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2019-09-12 |