| NPI | 1811142169 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VA 0101250745) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY p67291) |
| 208D00000X General Practice (Licence: ZZ 102186) | |
| 207R00000X Internal Medicine (Licence: VA 0101250745) | |
| Enumeration Date | 2008-11-28 |
| Last Update Date | 2014-12-03 |