| NPI | 1205253382 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NV 17843) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV 17843) | 
| 207R00000X Internal Medicine (Licence: CA A147050) | |
| Enumeration Date | 2014-03-26 | 
| Last Update Date | 2021-07-09 |