| NPI | 1790738862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: LA 304369) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME105915) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2017-02-10 |