| NPI | 1164785002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: CO DR.0069553) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: NY 280102) |
| Enumeration Date | 2012-06-15 |
| Last Update Date | 2023-10-26 |