| NPI | 1639309875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA MD60636000) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 52912) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AZ 45796) | |
| Enumeration Date | 2009-07-22 |
| Last Update Date | 2021-04-09 |