| NPI | 1912943218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY 33322) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY 966206) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2021-01-21 |