| NPI | 1164714697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 257198) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 257198) |
| Enumeration Date | 2011-05-02 |
| Last Update Date | 2020-01-31 |