| NPI | 1972836039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 106241-1) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 106241) |
| Enumeration Date | 2009-09-08 |
| Last Update Date | 2016-04-01 |