| NPI | 1306089040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: MI 4301091824) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5315035401) |
| Enumeration Date | 2009-04-10 |
| Last Update Date | 2019-06-21 |