| NPI | 1407063241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 264513) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA mt188619) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2012-06-05 |