| NPI | 1720288624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: GA 67738) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2007-00805) |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2014-07-15 |