| NPI | 1295001196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: MN 68774) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: MD D0085664) |
| Enumeration Date | 2012-03-26 |
| Last Update Date | 2021-07-12 |