| NPI | 1922020148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VA 0101241990) |
| Additional Taxonomies | 174400000X Specialist (Licence: VT 042-0007551) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2020-10-13 |