| NPI | 1033142526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 245267) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 00245267) |
| 207R00000X Internal Medicine (Licence: NY 245267) | |
| 363A00000X Physician Assistant (Licence: NY 006594) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 245267) | |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2016-09-08 |