| NPI | 1316196397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: CA A123868) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 60250309) |
| Enumeration Date | 2008-09-15 |
| Last Update Date | 2016-08-10 |