| NPI | 1124557301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OK 35503) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 94-09160) |
| Enumeration Date | 2017-06-09 |
| Last Update Date | 2020-05-11 |