| NPI | 1215596358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: MN 70769) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 8494) |
| Enumeration Date | 2019-06-12 |
| Last Update Date | 2024-05-30 |