| NPI | 1366616286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: GA 069600) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 135030) |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2022-01-10 |