| NPI | 1114966470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX M8990) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TN 35856) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2014-09-02 |