| NPI | 1225133754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 266725) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NH RT-1609) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NH 13994) | |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2013-01-29 |