| NPI | 1124625124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 3013518) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 12483870-1205) |
| Enumeration Date | 2020-10-04 |
| Last Update Date | 2023-07-04 |