| NPI | 1972508539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD073791) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NJ 25MA09417000) |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2014-11-05 |