| NPI | 1508279688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CT 71458) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 259800) |
| Enumeration Date | 2014-06-06 |
| Last Update Date | 2022-08-04 |