| NPI | 1801150602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MI L577748) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI L577748) |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2019-03-06 |