| NPI | 1245424415 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX M9815) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX M9815) | 
| Enumeration Date | 2007-08-30 | 
| Last Update Date | 2022-01-14 |