| NPI | 1578056727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IA R-12037) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 94-09503) |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2021-06-29 |