| NPI | 1912139627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD446132) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD446132) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NJ 25MA09698400) | |
| Enumeration Date | 2009-08-13 |
| Last Update Date | 2020-09-01 |