| NPI | 1366682445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 271369) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 42272) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 271369) | |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: NY 271369) | |
| Enumeration Date | 2009-03-02 |
| Last Update Date | 2015-02-20 |