| NPI | 1417163064 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: SC 34623) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 5462) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2015-05-21 |