| NPI | 1104032093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: FL OS11614) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 005203) |
| 207R00000X Internal Medicine (Licence: FL 0511614) | |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2023-05-04 |