| NPI | 1932461456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: GA 79840) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA L-251872) |
| Enumeration Date | 2012-06-11 |
| Last Update Date | 2018-08-15 |