| NPI | 1356600324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: MA 265271) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD452549) |
| 207R00000X Internal Medicine (Licence: PA MT201140) | |
| Enumeration Date | 2012-05-11 |
| Last Update Date | 2019-08-22 |