| NPI | 1861470676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MN 21067) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: SD 4207) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AZ 23991) | |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2018-04-26 |