| NPI | 1942281761 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: GA 57757) |
| Additional Taxonomies | 174400000X Specialist (Licence: AL 21287) |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2016-06-13 |