| NPI | 1366548364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: NY 274743) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NH RT1489) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2015-04-06 |