| NPI | 1407419039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME162173) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301506046) |
| Enumeration Date | 2019-04-18 |
| Last Update Date | 2023-07-07 |