| NPI | 1760470587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY 31496) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IN 01044036A) |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2020-12-10 |