| NPI | 1700975570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CO 48066) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WY 5842A) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NE 20108) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: SD 4071) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CT 041374) | |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2011-06-22 |