| NPI | 1154876928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 315647) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN23975) |
| Enumeration Date | 2016-08-22 |
| Last Update Date | 2022-07-28 |