| NPI | 1386664639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MD D0041216) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: DC MD16322) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VA 0101042749) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2015-12-16 |