| NPI | 1679577654 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: GA 019055) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 19055) |
| Enumeration Date | 2005-06-08 |
| Last Update Date | 2011-12-27 |