| NPI | 1205191699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME167029) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD457729) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 292937) | |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2024-06-11 |