| NPI | 1366602617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OK 29987) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA MD.203831) |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2018-03-08 |