| NPI | 1730392838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: GA 62630) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL 27707) |
| 207R00000X Internal Medicine (Licence: GA 062630) | |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2015-10-13 |