| NPI | 1265798847 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IL 036-155790) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 62056) | 
| Enumeration Date | 2012-04-08 | 
| Last Update Date | 2023-08-29 |