| NPI | 1306895966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 21165) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: KY 21165) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2020-12-02 |