| NPI | 1215920483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WI 55583-20) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MN 47847) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME142607) | |
| Enumeration Date | 2005-08-23 |
| Last Update Date | 2022-04-18 |