| NPI | 1891713061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 158746) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 1587461) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2025-09-11 |