| NPI | 1104003748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AZ 005222) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036.119058) |
| Enumeration Date | 2008-01-25 |
| Last Update Date | 2022-04-06 |