| NPI | 1144580184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: GA 76720) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 76720) |
| Enumeration Date | 2012-05-24 |
| Last Update Date | 2019-04-05 |