| NPI | 1568489565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: ND 3687) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MN 20466) |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2012-01-06 |