| NPI | 1619111887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 239366) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA L-239366) |
| Enumeration Date | 2009-05-01 |
| Last Update Date | 2012-09-17 |