| NPI | 1730520768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MS 27425) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.063414) |
| Enumeration Date | 2013-07-05 |
| Last Update Date | 2023-02-08 |