| NPI | 1225271745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: GA 76390) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 24583) |
| 207RC0000X Internal Medicine Cardiovascular Disease (Licence: MD D82285) | |
| 207RC0000X Internal Medicine Cardiovascular Disease (Licence: WV 24583) | |
| Enumeration Date | 2009-04-14 |
| Last Update Date | 2019-06-18 |