| NPI | 1255644555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WI 69193-20) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NH 14938) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 270212) | |
| Enumeration Date | 2010-07-15 |
| Last Update Date | 2020-12-23 |