| NPI | 1255312005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA A56256) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: LA 10025R) |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2023-05-06 |