| NPI | 1649689811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD470807) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.065119) |
| Enumeration Date | 2014-08-12 |
| Last Update Date | 2021-02-01 |