| NPI | 1548649254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: GA 99861) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 99861) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IA DO-05713) | |
| Enumeration Date | 2015-05-27 |
| Last Update Date | 2025-01-09 |