| NPI | 1871983577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MO 2018009248) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 308739) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 308739) | |
| Enumeration Date | 2015-02-02 |
| Last Update Date | 2022-07-07 |