| NPI | 1871678284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AL 17364) |
| Additional Taxonomies | 174400000X Specialist (Licence: AL 00017364) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2016-01-06 |