| NPI | 1053768614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME154869) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MN 65573) |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2022-05-17 |