| NPI | 1174009153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY 58570) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.072681) |
| Enumeration Date | 2018-07-12 |
| Last Update Date | 2024-06-26 |