| NPI | 1750710554 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: ND 17241) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101021290) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MN 68988) | |
| Enumeration Date | 2013-11-02 |
| Last Update Date | 2021-06-07 |