| NPI | 1851549356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA08200000) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: NJ 25MA08200000) |
| 207UN0901X Nuclear Medicine Nuclear Cardiology (Licence: NJ 25MA08200000) | |
| 207UN0902X Nuclear Medicine Nuclear Imaging & Therapy (Licence: NJ 25MA08200000) | |
| 261QP2300X Clinic/Center Primary Care (Licence: NJ 25MA08200000) | |
| Enumeration Date | 2008-09-09 |
| Last Update Date | 2025-05-08 |