| NPI | 1316102247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CT 050723) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 249562) |
| 207R00000X Internal Medicine (Licence: CT 050723) | |
| Enumeration Date | 2008-07-21 |
| Last Update Date | 2014-01-16 |