| NPI | 1902099286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: LA MD.207222) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2007017167) |
| Enumeration Date | 2007-08-21 |
| Last Update Date | 2019-01-24 |