| NPI | 1972846004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 283868) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 10794304-1205) |
| 207R00000X Internal Medicine (Licence: WA ML60366503) | |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2021-07-16 |