| NPI | 1649276015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NE 23124) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CO 29679) |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2017-03-22 |