| NPI | 1104806835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NM MD2014-0169) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AZ 20666) |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2014-09-17 |