| NPI | 1811150758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MO 2012017786) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036-120650) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2020-11-30 |