| NPI | 1851523500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MN 63889) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301094037) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA MD60541420) | |
| Enumeration Date | 2009-08-13 |
| Last Update Date | 2018-09-18 |