| NPI | 1023023504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CT 030077) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NM MD2005-0860) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: LA MD.13810R) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IA 36416) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NH 12354) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: SC 22820) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NJ 25MA07178200) | |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2023-07-05 |