| NPI | 1720061096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WI 46204) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MN 46177) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IA 01749) | |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2021-11-30 |