| NPI | 1477854453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 270119) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital |
| Enumeration Date | 2010-11-08 |
| Last Update Date | 2014-06-22 |