| NPI | 1780780882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TN 44852) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NC 9300759) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VA 0101053734) | |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2021-03-02 |