| NPI | 1245735703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MN 65811) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 29278) |
| 207R00000X Internal Medicine (Licence: MN 65811) | |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2021-06-22 |