| NPI | 1932107505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: LA 014753) |
| Additional Taxonomies | 174400000X Specialist (Licence: LA 014753) |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2019-03-06 |