| NPI | 1114088747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: PR 11662) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: NY 190399) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2011-05-19 |