| NPI | 1760479844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TN 66565) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 66565) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NC 2016-00305) | |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2024-02-09 |