| NPI | 1124017173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX F8392) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX F8392) |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2014-06-18 |