| NPI | 1972658060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TN 31153) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2006-01296) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2022-01-13 |