| NPI | 1366037756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 310080) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA F638) |
| Enumeration Date | 2021-03-08 |
| Last Update Date | 2021-04-29 |