| NPI | 1811206816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME155320) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101257254) |
| Enumeration Date | 2010-09-25 |
| Last Update Date | 2022-08-16 |