| NPI | 1720372980 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: MA 259018) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 259018) |
| 207R00000X Internal Medicine (Licence: MA 249220) | |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2019-10-18 |