| NPI | 1114918620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MI 4301047259) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IN 01076290A) |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2020-10-23 |