| NPI | 1831305150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CT 050625) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 229120) |
| 207R00000X Internal Medicine (Licence: CT 050625) | |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2014-11-20 |