| NPI | 1972586964 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 214373) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 209015) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 209015) | |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2016-06-24 |