| NPI | 1851731608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CT 65428) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX R0045) |
| 207R00000X Internal Medicine (Licence: IA R09890) | |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2020-05-15 |