| NPI | 1376915330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WI 74524-20) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: WI 74524-20) |
| Enumeration Date | 2015-10-29 |
| Last Update Date | 2024-06-11 |