| NPI | 1508069816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 243423) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT190752) |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2014-05-12 |