| NPI | 1831288158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: PA MD056705L) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 200929) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2020-08-18 |