| NPI | 1619903705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WY 4505A) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MT 6651) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2021-04-08 |