| NPI | 1811920630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: TN 7875) |
| Additional Taxonomies | 174400000X Specialist (Licence: TN 7875) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2014-12-03 |