| NPI | 1740261841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MN 42751) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WI 44160) |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2020-08-20 |