| NPI | 1730187063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: ND 9600778) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 9600778) |
| Enumeration Date | 2005-07-11 |
| Last Update Date | 2021-06-11 |