| NPI | 1548201569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: SC 83204) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME 88048) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD453708) | |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2020-05-21 |