| NPI | 1306331772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: OH 58.032162) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5315094467) |
| 207R00000X Internal Medicine (Licence: MI 5101024325) | |
| Enumeration Date | 2018-06-27 |
| Last Update Date | 2021-05-06 |