| NPI | 1154426740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 001121) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY X001121-1) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2008-06-02 |