| NPI | 1710989074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: VA 0101043561) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: PA MD444415) |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2017-03-10 |