| NPI | 1932463809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: ND 17494) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 56619) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MN 56619) | |
| Enumeration Date | 2012-06-26 |
| Last Update Date | 2022-03-31 |