| NPI | 1326070319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: FL 41339) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL 41339) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2020-02-25 |