| NPI | 1225118748 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208600000X Surgery (Licence: TX M9556) | 
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD427279) | 
| Enumeration Date | 2006-10-17 | 
| Last Update Date | 2017-01-16 |