| NPI | 1629366554 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: PA OS019307) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT014011) |
| Enumeration Date | 2011-07-12 |
| Last Update Date | 2020-08-13 |