| NPI | 1851477475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ MA052985) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ MA52985) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NJ 25MA05298500) | |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2020-06-17 |