| NPI | 1164427183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 42361) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD-028840-E) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2020-10-23 |