| NPI | 1790722304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 240329) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 224079) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2017-03-10 |