| NPI | 1679830590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: IN 02004304A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 02004304A) |
| 208D00000X General Practice (Licence: IN 02004304A) | |
| Enumeration Date | 2012-04-17 |
| Last Update Date | 2021-02-17 |