| NPI | 1255727160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WI 84179) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 61459) |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2024-06-18 |