| NPI | 1841456522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MO 2013030329) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH not issued yet) |
| Enumeration Date | 2008-08-01 |
| Last Update Date | 2022-03-07 |