| NPI | 1396764403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VT 042-0006968) |
| Additional Taxonomies | 174400000X Specialist (Licence: VT 42-0006968) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2018-11-09 |