| NPI | 1104029990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: AZ 43573) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: CA A116223) |
| 207RC0000X Internal Medicine Cardiovascular Disease (Licence: FL TPME4861) | |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2022-12-02 |