| NPI | 1780734939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 128933-1) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 128933-1) |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2025-09-11 |