| NPI | 1376524579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MD D0034663) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: DC MD17986) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NC 29618) | |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2007-07-08 |