| NPI | 1740470459 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CT 69384) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 254009) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL 133801) | |
| Enumeration Date | 2007-07-29 |
| Last Update Date | 2021-12-09 |