| NPI | 1588654149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: LA MD.14582R) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD065959L) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TN MD0000033956) | |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2022-05-05 |