| NPI | 1780094805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NH 32071) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 289454) |
| Enumeration Date | 2014-04-28 |
| Last Update Date | 2025-02-05 |