| NPI | 1083874630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VA 0101252036) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2011-01180) |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2023-10-30 |