| NPI | 1912094004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 098757) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: NY 098757) |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2007-07-08 |