| NPI | 1801080080 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 260980) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD432082) |
| Enumeration Date | 2007-08-30 |
| Last Update Date | 2016-02-19 |