| NPI | 1104804368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 196075) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME150292) |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2021-12-03 |