| NPI | 1174608772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AZ 3196) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 3196) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2009-03-30 |