| NPI | 1710976295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX U5224) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 225852) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 225852) | |
| Enumeration Date | 2005-10-18 |
| Last Update Date | 2023-08-04 |