| NPI | 1114333721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MN 59324) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 59324) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WI 20821) | |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2021-06-29 |