| NPI | 1225304249 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 273803)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 273803)  | 
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NY 273803)  | |
| Enumeration Date | 2012-03-23 | 
| Last Update Date | 2023-07-07 |