| NPI | 1063650836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IN 02004345A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101019073) |
| Enumeration Date | 2009-02-01 |
| Last Update Date | 2023-10-16 |