| NPI | 1649367731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 149191-1) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 149191) |
| 207RC0000X Internal Medicine Cardiovascular Disease (Licence: NY 149191) | |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2014-01-29 |