| NPI | 1871021758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MI 4301504328) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX R8785) |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2024-07-11 |