| NPI | 1053654277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: NY 285559) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 9020) |
| 207R00000X Internal Medicine (Licence: NY 285559) | |
| Enumeration Date | 2013-04-05 |
| Last Update Date | 2020-06-09 |