| NPI | 1871572677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: IA 26214) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA MD-26214) |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2021-02-15 |