| NPI | 1770786618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NM MD2014-0139) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 023364) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AL MD28456) | |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2014-10-31 |