| NPI | 1700064342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CO 58500) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 002184) |
| Enumeration Date | 2008-02-06 |
| Last Update Date | 2022-04-12 |