| NPI | 1669687711 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MN 55127) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD434668) | 
| 207R00000X Internal Medicine (Licence: PA MT 186577) | |
| Enumeration Date | 2007-05-11 | 
| Last Update Date | 2024-02-28 |