| NPI | 1649443649 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: NY 230538) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 230538) | 
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 230538) | |
| Enumeration Date | 2008-04-10 | 
| Last Update Date | 2010-04-13 |