| NPI | 1174904254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: MI 4301503479) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301503479) |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2021-03-08 |