| NPI | 1215389903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY 52264) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.068635) |
| Enumeration Date | 2016-07-06 |
| Last Update Date | 2023-01-18 |