| NPI | 1104867936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MS 06387) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MS 6387) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: GA 056686) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AL 00027291) | |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2012-12-07 |