| NPI | 1508839622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: TN MD24310) |
| Additional Taxonomies | 174400000X Specialist (Licence: TN MD024310) |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2022-03-22 |