| NPI | 1154361715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WI 60755) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 39503) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2019-10-07 |