| NPI | 1104310234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX V0120) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2018017138) |
| Enumeration Date | 2018-06-21 |
| Last Update Date | 2024-06-07 |