| NPI | 1720035835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: GA 069424) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX M2756) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2016-02-19 |