| NPI | 1508220278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AL 38167) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 62528) |
| Enumeration Date | 2016-04-08 |
| Last Update Date | 2022-07-01 |