| NPI | 1356315501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IA 40166) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD057504L) |
| 207R00000X Internal Medicine (Licence: IA 40166) | |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2012-07-02 |