| NPI | 1912955642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 261528) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 261528) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2021-11-04 |