| NPI | 1134495104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MT 76231) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WY 13608C) |
| Enumeration Date | 2012-03-23 |
| Last Update Date | 2021-06-29 |