| NPI | 1154473635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MI 4301094579) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI #4301094579) |
| 207R00000X Internal Medicine (Licence: PA MT187681) | |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2019-02-01 |