| NPI | 1295050169 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CT 056654) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VT 042.0012683) |
| Enumeration Date | 2010-04-02 |
| Last Update Date | 2017-10-12 |