| NPI | 1164884177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MN 73131) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 82639) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: SC 82639) | |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2023-09-14 |