| NPI | 1912919911 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA A74833) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A74833) |
| 207R00000X Internal Medicine (Licence: CA A74833) | |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2012-09-27 |