| NPI | 1912524836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4351046483) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 345643) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 1026314) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VA 0101289932) | |
| Enumeration Date | 2020-06-26 |
| Last Update Date | 2026-08-27 |