| NPI | 1710408547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AZ 60308) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 64205) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MN 64205) | |
| Enumeration Date | 2017-07-01 |
| Last Update Date | 2023-09-25 |