| NPI | 1922200930 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: MA 240064) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 045042) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2021-06-22 |