| NPI | 1659376689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: CA 20A6509) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 007666) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2022-11-04 |