| NPI | 1598808180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: FL ME103075) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 236526) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2022-11-03 |