| NPI | 1366893141 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 316006) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101022274) |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2022-06-28 |