| NPI | 1174747810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME41465) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL Me41465) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2026-07-13 |