| NPI | 1306982491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME41671) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME0041671) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY 49729) | |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2021-07-09 |