| NPI | 1679780373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME135622) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 61823) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: LA MD.206105) | |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2018-08-17 |