| NPI | 1104856780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 15076501) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: GA 35901) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: GA 035901) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2020-05-18 |