| NPI | 1124466412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 288886) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 288886) |
| 207R00000X Internal Medicine (Licence: MA 265223) | |
| Enumeration Date | 2013-06-07 |
| Last Update Date | 2021-05-06 |