| NPI | 1588662753 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: GA 56901) |
| Additional Taxonomies | 174400000X Specialist (Licence: LA 11044R) |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2020-05-08 |