| NPI | 1275797342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: AL 31961) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: AL 31961) |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2024-02-01 |