| NPI | 1508904186 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WI 45931-20)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 45931-020)  | 
| Enumeration Date | 2007-02-03 | 
| Last Update Date | 2021-12-01 |