| NPI | 1679835722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 293545-1) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125061501) |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2018-05-24 |