| NPI | 1871040253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 268559) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: NJ 25MA09818800) |
| Enumeration Date | 2016-09-02 |
| Last Update Date | 2022-05-26 |