| NPI | 1043620719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TN MD0000056838) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL me126950) |
| Enumeration Date | 2014-05-05 |
| Last Update Date | 2020-06-04 |