| NPI | 1770931339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 323839) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 32333) |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2024-10-10 |