| NPI | 1255397816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: GA 079064) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NC 2017-02347) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VA 0101236468) | |
| Enumeration Date | 2006-04-24 |
| Last Update Date | 2022-03-04 |