| NPI | 1205217981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: PA MD465682) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT209760) |
| Enumeration Date | 2015-06-17 |
| Last Update Date | 2021-06-22 |