| NPI | 1952457178 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NC 2008-00564)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 224845)  | 
| Enumeration Date | 2007-01-29 | 
| Last Update Date | 2012-10-30 |