| NPI | 1679830632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL 155596) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CT 64000) |
| Enumeration Date | 2012-04-16 |
| Last Update Date | 2023-09-11 |