| NPI | 1306233804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA OS021296) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV #ED0575A) |
| 207R00000X Internal Medicine (Licence: NC 209324) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY 04260) | |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2021-07-13 |