| NPI | 1164650834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MI 4301107538) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 51015) |
| Enumeration Date | 2009-07-01 |
| Last Update Date | 2016-01-13 |