| NPI | 1407850381 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WI 27555) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IA 25740) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MN 52565) | |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2015-06-04 |