| NPI | 1861514127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CT 56694) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD27738) |
| Enumeration Date | 2007-04-05 |
| Last Update Date | 2019-06-16 |