| NPI | 1811987340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NH 14005) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 217618) |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2019-06-27 |