| NPI | 1316969876 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY 44574) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D069888) |
| 207R00000X Internal Medicine (Licence: GA 053693) | |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2022-03-30 |