| NPI | 1699121541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: AZ 55803) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R75867) |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2020-09-03 |