| 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 |