| NPI | 1386292175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: NY 024332-01) |
| Enumeration Date | 2019-08-27 |
| Last Update Date | 2025-05-27 |