| NPI | 1689648149 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 225097) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 225097) | 
| Enumeration Date | 2006-02-13 | 
| Last Update Date | 2016-03-10 |