| NPI | 1003101148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: MA 257541) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 247695) |
| 207RC0000X Internal Medicine Cardiovascular Disease (Licence: MA 357541) | |
| Enumeration Date | 2011-06-16 |
| Last Update Date | 2018-08-22 |