| NPI | 1790186252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: NY 303593) |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: RI MD18366) |
| Enumeration Date | 2014-09-15 |
| Last Update Date | 2023-09-27 |