| NPI | 1215381421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY 56565) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 68438) |
| Enumeration Date | 2016-04-14 |
| Last Update Date | 2022-07-07 |