| NPI | 1821450511 |
|---|---|
| Other Name | N/A N/A |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MD D98002) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MO 2019013241) |
| 207R00000X Internal Medicine (Licence: PA MD464643) | |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2023-07-13 |