| NPI | 1548505142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AZ 53167) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 53167) |
| 208000000X Pediatrics (Licence: AZ 53167) | |
| Enumeration Date | 2012-12-07 |
| Last Update Date | 2020-07-30 |