| NPI | 1811169543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CT 71530) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: ME 017782) |
| Enumeration Date | 2008-04-02 |
| Last Update Date | 2022-08-15 |