| NPI | 1902244692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MN 71456) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101260495) |
| Enumeration Date | 2013-06-05 |
| Last Update Date | 2022-10-05 |