| NPI | 1306259403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 288958) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 259804) |
| Enumeration Date | 2014-06-05 |
| Last Update Date | 2022-11-04 |