| NPI | 1801899158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WV 27177) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME83898) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD068643L) | |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2022-04-06 |