| NPI | 1548605108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY 53614) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2016-00537) |
| Enumeration Date | 2013-05-08 |
| Last Update Date | 2021-09-02 |