| NPI | 1780774968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 75491) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 206872) |
| 207R00000X Internal Medicine (Licence: MA 75491) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 206872) | |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2021-02-24 |