| NPI | 1174185904 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MI 5101026290) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5151014105) | 
| Enumeration Date | 2019-07-02 | 
| Last Update Date | 2022-06-20 |