| NPI | 1255698163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: SC 39407) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL39407) |
| Enumeration Date | 2012-04-16 |
| Last Update Date | 2021-05-07 |