| NPI | 1548495849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: GA 85754) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 246463-1) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 246463-1) | |
| Enumeration Date | 2009-05-15 |
| Last Update Date | 2020-08-06 |