| NPI | 1447498225 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA A100369) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 251274) | 
| Enumeration Date | 2009-02-02 | 
| Last Update Date | 2025-10-09 |