| NPI | 1245681659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TN 65950) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL39709) |
| 207R00000X Internal Medicine (Licence: TN 65950) | |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2022-12-14 |