| NPI | 1790951606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CT 84620) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA C169557) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 278667) | |
| 207R00000X Internal Medicine (Licence: CT 84620) | |
| Enumeration Date | 2008-05-01 |
| Last Update Date | 2026-06-11 |