| NPI | 1457362659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TN 48493) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 19092) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2021-06-14 |