| NPI | 1578524930 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TN 41124) |
| Additional Taxonomies | 202K00000X (Licence: TN 41124) |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2019-09-20 |