| NPI | 1114300522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: PA MD464496) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD464496) |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2022-09-21 |