| NPI | 1063078046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AZ 61704) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R77302) |
| Enumeration Date | 2019-05-15 |
| Last Update Date | 2022-06-24 |