| NPI | 1417959610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 75966) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: RI MD08923) |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2020-04-20 |