| NPI | 1952485740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: ND 4722) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MN 45526) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MO R7H383) | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2008-05-29 |