| NPI | 1922056134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA C132359) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VT 0420011325) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2020-04-08 |