| NPI | 1790861920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NE 22853) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IA 35616) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2018-11-05 |