| NPI | 1215904842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: SC 20213) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD013284E) |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2015-11-02 |