| NPI | 1659805125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NH 23965) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 305457) |
| Enumeration Date | 2017-04-12 |
| Last Update Date | 2023-08-14 |