| NPI | 1811493778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 65878) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 29296) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MN 65878) | |
| Enumeration Date | 2018-03-31 |
| Last Update Date | 2024-10-02 |