| NPI | 1598759961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: MA 222042) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 222042) |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2011-03-16 |