| NPI | 1194176594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NV 22810) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT212203) |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2022-10-11 |