| NPI | 1881789139 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KS 04-32078)  | 
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MO 2006031507)  | 
| Enumeration Date | 2006-10-03 | 
| Last Update Date | 2018-12-05 |