| NPI | 1861766693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: MN 64755) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD456341) |
| 207RC0000X Internal Medicine Cardiovascular Disease (Licence: PA MD456341) | |
| Enumeration Date | 2012-02-24 |
| Last Update Date | 2024-09-28 |