| NPI | 1881031045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: FL ME150689) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 265145) |
| Enumeration Date | 2013-05-29 |
| Last Update Date | 2021-07-23 |