| NPI | 1760486583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MI HJ4301064728) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI HJ4301064728) |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2021-11-01 |