| NPI | 1780753319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VA 0101232451) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101232451) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2023-08-10 |