| NPI | 1114470366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL OS14940) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL UO4935) |
| Enumeration Date | 2016-07-24 |
| Last Update Date | 2022-08-23 |