| NPI | 1679518914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: WV 13191) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: KY 28786) |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2012-10-02 |