| NPI | 1942351465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 253971) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 225292) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MI 4301100294) | |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2021-05-06 |