| NPI | 1962412213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 25378) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: NC 64010) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2007-10-29 |