| NPI | 1194188581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA A155785) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A155785) |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2023-02-08 |