| NPI | 1164426151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: GA 021027) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 21027) |
| Enumeration Date | 2005-06-08 |
| Last Update Date | 2011-12-27 |