| NPI | 1790855534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AR E-5870) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0116017314) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2011-10-04 |