| NPI | 1780679993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 191924) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: NY 191924) |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2011-01-05 |