| NPI | 1962722819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: IA MD-40966) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R-8877) |
| 207RC0000X Internal Medicine Cardiovascular Disease (Licence: MN 58749) | |
| Enumeration Date | 2010-06-02 |
| Last Update Date | 2021-09-01 |