| NPI | 1235376302 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY 44332) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 44332) |
| Enumeration Date | 2009-01-12 |
| Last Update Date | 2016-07-25 |