| NPI | 1205837887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 203570) |
| Additional Taxonomies | 174400000X Specialist (Licence: RI MD11417) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2008-12-28 |