| NPI | 1336598796 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA 160796) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 267673) | 
| Enumeration Date | 2016-06-07 | 
| Last Update Date | 2022-09-08 |