| NPI | 1265400014 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: GA 058379) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0061852) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2014-04-02 |