| NPI | 1679739551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: NY 249822) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: PA MD483608) |
| Enumeration Date | 2008-07-31 |
| Last Update Date | 2024-05-01 |