| NPI | 1689936809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 259503) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: FL ME142400) |
| 207RI0011X Internal Medicine Interventional Cardiology (Licence: FL ME142400) | |
| 207R00000X Internal Medicine (Licence: FL ME142400) | |
| 207R00000X Internal Medicine (Licence: MA 251750) | |
| Enumeration Date | 2012-06-13 |
| Last Update Date | 2020-02-06 |