| NPI | 1114906542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VA 0101053673) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WV 20239) |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2023-02-03 |