| NPI | 1871597625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VA 0101047687) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 010147687) |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2019-02-11 |