| NPI | 1912904913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AL MD.29028) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: LA 15209R) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME 97412) | |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2016-08-16 |