| NPI | 1073779625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: GA 82948) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 21412) |
| Enumeration Date | 2008-08-04 |
| Last Update Date | 2023-11-07 |