| NPI | 1306813142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 1862781) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VT 0420008933) |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2021-06-11 |