| NPI | 1619355591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 308581) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP03288) |
| Enumeration Date | 2015-05-12 |
| Last Update Date | 2021-07-22 |