| NPI | 1619388626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: PA OS022231) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT015923) |
| 207RC0000X Internal Medicine Cardiovascular Disease (Licence: WI 73234-21) | |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2023-04-05 |