| NPI | 1902951270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AL 30412) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MO 2007008861) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY 41579) | |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2011-07-18 |