| NPI | 1063418572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CO 20789) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NE 19652) |
| Enumeration Date | 2005-06-21 |
| Last Update Date | 2014-06-12 |