| NPI | 1699883843 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: UT 1714941205)  | 
| Additional Taxonomies | 2086S0129X  (Licence: UT 1714941205)  | 
| Enumeration Date | 2006-08-28 | 
| Last Update Date | 2021-08-10 |