| NPI | 1164411880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: GA 44744) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: TN 24337) |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2024-01-25 |