| NPI | 1003868209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CO 61365) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MD D56290) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY 45769) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2021-02-23 |