| NPI | 1316929813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: LA MD.021553) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 021553) |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2022-05-27 |