| NPI | 1063772531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MI 4301501666) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301501666) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NC 2015-01369) | |
| Enumeration Date | 2012-05-18 |
| Last Update Date | 2020-08-04 |