| NPI | 1174151211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: MN 69600) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 30757) |
| Enumeration Date | 2020-04-01 |
| Last Update Date | 2023-06-30 |