| NPI | 1548605744 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME136357) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 53054) |
| Enumeration Date | 2013-05-02 |
| Last Update Date | 2022-09-02 |