| NPI | 1235131947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: KY 18969) |
| Additional Taxonomies | 174400000X Specialist (Licence: KY 18969) |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2016-05-23 |