| NPI | 1417263450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: CA A126425) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME115907) |
| 207R00000X Internal Medicine (Licence: MO 2010015146) | |
| Enumeration Date | 2010-08-27 |
| Last Update Date | 2023-04-26 |