| NPI | 1043659840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: GA 82164) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125-062764) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MI 4301109203) | |
| Enumeration Date | 2013-06-14 |
| Last Update Date | 2019-12-19 |