| NPI | 1467765099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: RI MD16235) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: NY 270808) |
| Enumeration Date | 2010-07-24 |
| Last Update Date | 2018-06-14 |