| NPI | 1700930120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: MA 238385) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 229225) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2011-05-05 |