| NPI | 1093955148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: SD 11457) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT192428) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD443590) | |
| Enumeration Date | 2009-03-03 |
| Last Update Date | 2024-07-31 |