| NPI | 1720342777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: ID M-14148) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 56645) |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2018-04-11 |