| NPI | 1588620108 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TN MD17955)  | 
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VA 0101237024)  | 
| Enumeration Date | 2006-04-22 | 
| Last Update Date | 2017-02-16 |