| NPI | 1689101511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: SC 89684) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 009056) |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2023-10-04 |