| NPI | 1265688824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: GA 81127) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 729-L) |
| Enumeration Date | 2008-08-14 |
| Last Update Date | 2019-02-20 |