| NPI | 1336792357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WV 1241) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 8636) |
| Enumeration Date | 2019-07-18 |
| Last Update Date | 2024-01-12 |