| NPI | 1912092115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MD D0067246) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 054288) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VA 0101269224) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2021-04-13 |