| NPI | 1124105002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: NY 001090) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 001090) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2012-07-20 |