| NPI | 1457779829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AZ R76110) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY R3411) |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2023-03-07 |