| NPI | 1700808508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: LA 02359R) |
| Additional Taxonomies | 208600000X Surgery (Licence: LA 02459r) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2011-06-10 |