| NPI | 1255696225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: DE C1-0024375) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD455574) |
| Enumeration Date | 2012-07-05 |
| Last Update Date | 2021-08-06 |