| NPI | 1164477766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: MO R3H62) |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2024-06-19 |