| NPI | 1790999092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WI 81685-20) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 40844) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MI 4301079802) | |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2023-04-06 |