| NPI | 1114167988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MI 4301101719) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 207r00000x) |
| Enumeration Date | 2009-03-05 |
| Last Update Date | 2015-06-26 |