| NPI | 1174842223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101250875) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: ME MD24334) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NH 21080) | |
| Enumeration Date | 2010-05-27 |
| Last Update Date | 2021-06-10 |