| NPI | 1619226057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD463667) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT202749) |
| Enumeration Date | 2012-08-30 |
| Last Update Date | 2018-09-17 |