| NPI | 1861425712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: ME 015610) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NH 12201) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2016-02-11 |