| NPI | 1003337973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: ND 19014) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2017015904) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MN 72507) | |
| Enumeration Date | 2017-06-30 |
| Last Update Date | 2023-06-05 |