| NPI | 1366423345 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 157330) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 157330) | 
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NH 23907) | |
| Enumeration Date | 2005-11-08 | 
| Last Update Date | 2023-05-11 |