| NPI | 1851682298 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NJ 25MA10330000) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA10330000) | 
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: NJ 25MA10330000) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-04-19 | 
| Last Update Date | 2024-04-12 |