| NPI | 1093783532 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY 03506)  | 
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL OS15064)  | 
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TN DO1370)  | |
| Enumeration Date | 2006-03-10 | 
| Last Update Date | 2024-12-17 |