| NPI | 1679968960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 321684) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101261450) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VA 0101261450) | |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2023-04-04 |