| NPI | 1679735252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VA 0101257865) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101257865) |
| 207R00000X Internal Medicine (Licence: PA MT192962) | |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2021-11-08 |