| NPI | 1376717793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: NY 234988-1) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 234988-1) |
| 207RI0011X Internal Medicine Interventional Cardiology (Licence: NY 234988-1) | |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2012-04-25 |