| NPI | 1285808311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: VA 0101245486) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 46496) |
| 207R00000X Internal Medicine (Licence: TX M2089) | |
| Enumeration Date | 2008-04-18 |
| Last Update Date | 2011-02-28 |