| NPI | 1962415034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: DC MD035587) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101238146) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2019-12-10 |