| NPI | 1558624296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA MD60542229) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125061079) |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2022-12-12 |