| NPI | 1255443461 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: GA 058754) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 200300616) |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2022-02-01 |