| NPI | 1023371739 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY 50551) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2015-02076) | 
| 207R00000X Internal Medicine (Licence: KY 50551) | |
| Enumeration Date | 2012-06-18 | 
| Last Update Date | 2024-03-15 |