| NPI | 1053670166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MS 26840) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY r3053) |
| Enumeration Date | 2012-05-09 |
| Last Update Date | 2019-06-24 |