| NPI | 1912203290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 306000) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 306000) |
| 207R00000X Internal Medicine (Licence: CT 52335) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CT 52335) | |
| Enumeration Date | 2011-02-02 |
| Last Update Date | 2023-08-23 |