| NPI | 1679765481 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MD D0056089) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0056089) | 
| Enumeration Date | 2007-08-15 | 
| Last Update Date | 2013-10-21 |