| NPI | 1962663344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 246218) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 246218) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CT 053797) | |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2022-09-30 |