| NPI | 1639275084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 222928) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME165993) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME165993) | |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2024-10-14 |