| NPI | 1134378060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 290114) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 290114) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 250714) | |
| 282N00000X General Acute Care Hospital | |
| Enumeration Date | 2008-09-16 |
| Last Update Date | 2022-07-21 |