| NPI | 1508805227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 140798) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 140798) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2008-06-02 |