| NPI | 1316017742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: MI 4301039549) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301039549) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2012-04-25 |