| NPI | 1356339618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: ID M-6985) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CO 32416) |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2024-01-03 |