| NPI | 1023314895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 262718) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 262718) |
| Enumeration Date | 2011-01-26 |
| Last Update Date | 2018-03-17 |