| NPI | 1538157417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX 45092) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD056993L) |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2021-01-07 |