| NPI | 1083744403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MN 65305) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A81632) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OK 28865) | |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2024-01-05 |