| NPI | 1699761106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AL 14470) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: UT 1846890-1205) |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2019-10-11 |