| NPI | 1376606830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY 52292) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA 60212959) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TN MD43981) | |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2019-05-30 |