| NPI | 1386759066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 248354) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 230088) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NC 2015-00229) | |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2016-08-09 |