| NPI | 1013201946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL OS14455) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT014242) |
| Enumeration Date | 2011-06-08 |
| Last Update Date | 2018-03-17 |