| NPI | 1144466111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME167835) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 237179) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: ND PT 14024) | |
| Enumeration Date | 2008-12-22 |
| Last Update Date | 2024-05-01 |