| NPI | 1811979974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA 011714) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: LA 011714) |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2023-04-13 |