| NPI | 1912221896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: NY 264015) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036-133352) |
| Enumeration Date | 2010-03-20 |
| Last Update Date | 2022-07-21 |