| NPI | 1770761793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101253200) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VA 0213001912) |
| Enumeration Date | 2008-01-31 |
| Last Update Date | 2020-04-02 |