| NPI | 1801008446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 096722) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 096722) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY H90121970783) | |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2012-02-28 |