| NPI | 1104209378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: ND 17378) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301108170) |
| Enumeration Date | 2015-07-06 |
| Last Update Date | 2022-02-24 |