| NPI | 1558344432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX E3550) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TN 6649) |
| Enumeration Date | 2005-11-23 |
| Last Update Date | 2008-01-10 |