| NPI | 1851679690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD472164) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT198647) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY 51046) | |
| Enumeration Date | 2011-07-27 |
| Last Update Date | 2022-05-11 |