| NPI | 1073572186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MD D36192) |
| Additional Taxonomies | 174400000X Specialist (Licence: MD D0036192) |
| Enumeration Date | 2006-03-20 |
| Last Update Date | 2025-09-15 |