| NPI | 1235369950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: SD 8419) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO T2009009823) |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2022-09-22 |