| NPI | 1952632390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 1025348) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 259052) |
| Enumeration Date | 2010-01-25 |
| Last Update Date | 2025-12-02 |