| NPI | 1538246822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: TN 49015) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL28963) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2014-12-03 |