| NPI | 1578806212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: VA 0101257457) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101257457) |
| Enumeration Date | 2013-04-01 |
| Last Update Date | 2022-06-29 |