| NPI | 1912970716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AK 4068) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AK 4068) |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2012-09-27 |