| NPI | 1003144528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 245639) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 250579-1) |
| Enumeration Date | 2009-11-20 |
| Last Update Date | 2012-02-13 |