| NPI | 1689027799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY 56805) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125068394) |
| Enumeration Date | 2016-07-14 |
| Last Update Date | 2022-06-20 |