| NPI | 1134359342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 250635) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 250635) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 250635) | |
| Enumeration Date | 2009-07-22 |
| Last Update Date | 2023-07-02 |