| NPI | 1821351586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 279207) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 251804) |
| 207R00000X Internal Medicine (Licence: NY 279207) | |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2019-06-27 |