| NPI | 1679769202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VA 0102201784) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0102201784) |
| Enumeration Date | 2007-09-18 |
| Last Update Date | 2021-08-19 |