| NPI | 1235664442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: GA 95313) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 95313) |
| Enumeration Date | 2017-04-25 |
| Last Update Date | 2023-08-15 |