| NPI | 1629048632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: GA 30762) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NJ 25MB0593880) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: SC 83246) | |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2021-06-30 |