| NPI | 1184115024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 309084) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP04245) |
| Enumeration Date | 2018-05-26 |
| Last Update Date | 2025-02-10 |