| NPI | 1003871955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MN 66097) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VT 042-0011122) |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2019-08-13 |