| NPI | 1275539702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: VA 0101221234) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AL 28644) |
| Enumeration Date | 2005-06-21 |
| Last Update Date | 2012-03-16 |