| NPI | 1073745881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: LA 322084) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01067109A) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME135806) | |
| Enumeration Date | 2009-08-12 |
| Last Update Date | 2020-06-24 |