| NPI | 1639447360 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME111787) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME 111787) |
| 207R00000X Internal Medicine (Licence: FL TRN 13357) | |
| Enumeration Date | 2011-12-08 |
| Last Update Date | 2016-08-04 |