| NPI | 1255390415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 118428) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 118428-1) |
| 207RC0000X Internal Medicine Cardiovascular Disease (Licence: NY 118428-1) | |
| 207RC0200X Internal Medicine Critical Care Medicine (Licence: NY 118428-1) | |
| 207RC0000X Internal Medicine Cardiovascular Disease (Licence: NY 118428) | |
| 207L00000X Anesthesiology (Licence: NY 118428) | |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2012-10-30 |