| NPI | 1962410746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: GA 081734) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2006-01173) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2019-03-12 |