| NPI | 1154354033 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TN 34198) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY 29754) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VA 0101247081) | |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2015-07-28 |