| NPI | 1942561758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 260820) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 251532) |
| Enumeration Date | 2012-06-07 |
| Last Update Date | 2018-03-22 |