| NPI | 1699157743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: AZ 63236) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.131889) |
| 207RC0000X Internal Medicine Cardiovascular Disease (Licence: FL TPME4908) | |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2022-12-01 |