| NPI | 1134518566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: PA OS019325) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 979075464) |
| Enumeration Date | 2015-01-22 |
| Last Update Date | 2020-08-30 |