| NPI | 1003120338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 282746) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT196348) |
| 207R00000X Internal Medicine (Licence: NY 282746) | |
| Enumeration Date | 2010-07-28 |
| Last Update Date | 2017-04-25 |