| NPI | 1972831618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA 14007) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL UO2280) |
| Enumeration Date | 2009-11-18 |
| Last Update Date | 2016-01-21 |