| NPI | 1275947848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MI FS7580548) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101020895) |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2021-03-26 |