| NPI | 1801874045 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NJ 25MA06397500)  | 
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: NJ 25MA06397500)  | 
| Enumeration Date | 2006-01-06 | 
| Last Update Date | 2010-01-28 |