| NPI | 1578672267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: AZ 43491) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 40609) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2020-09-03 |