| NPI | 1225247562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 255976) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA mt185110) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: LA md201464) | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2022-04-19 |