| NPI | 1194715607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME112813) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA 48198) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: HI 14025) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OR 27181) | |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2020-09-10 |