| NPI | 1164943924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 323213) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT017842) |
| Enumeration Date | 2017-07-03 |
| Last Update Date | 2023-07-17 |