| NPI | 1285954180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 55129) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 244767) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CT 55129) | |
| Enumeration Date | 2010-06-03 |
| Last Update Date | 2016-06-22 |