| NPI | 1255660718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NC 201200333) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: NY 254341) |
| Enumeration Date | 2009-12-12 |
| Last Update Date | 2013-08-16 |