| NPI | 1982600870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CO 41901) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KS 04-28814) |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2022-01-13 |