| NPI | 1114455755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME148988) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 305812) |
| Enumeration Date | 2017-05-26 |
| Last Update Date | 2021-06-15 |