| NPI | 1558361063 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME36607)  | 
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AL 7355)  | 
| Enumeration Date | 2005-07-26 | 
| Last Update Date | 2017-02-11 |