| NPI | 1104870658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 093796) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 093796) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2009-10-23 |