| NPI | 1487621017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MN 49929) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WI 46253) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX M3915) | |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2013-10-02 |