| NPI | 1013981588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD039160-E) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD039160E) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2020-07-30 |