| NPI | 1316100258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: WV 27816) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2008013469) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2018-05-16 |