| NPI | 1811002173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VA 0101025342) |
| Additional Taxonomies | 174400000X Specialist (Licence: WV 09645) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2016-08-24 |