| NPI | 1750476115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NH 6598) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VT 042-0006646) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2011-07-21 |