| NPI | 1033311030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME154179) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 17092) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX N9385) | |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2022-02-02 |