| NPI | 1700023579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 274815) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207UN0901X Nuclear Medicine, Nuclear Cardiology (Licence: NY 274815) | |
| Enumeration Date | 2009-01-14 |
| Last Update Date | 2015-08-21 |