| NPI | 1801970645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WV 19907) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME.151357) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2021-08-17 |