| NPI | 1669459095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX H6629) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX H6629) |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2022-04-12 |