| NPI | 1710957535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OK 19332) |
| Additional Taxonomies | 174400000X Specialist (Licence: OK 19332) |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2014-03-14 |