| NPI | 1710154315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NM MD2011-0703) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM GME) |
| Enumeration Date | 2008-05-13 |
| Last Update Date | 2015-06-16 |