| NPI | 1790192672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MO 2021036284) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 290770) |
| Enumeration Date | 2014-07-12 |
| Last Update Date | 2021-11-09 |