| NPI | 1356572556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: PR 17676) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 17676) |
| 207R00000X Internal Medicine (Licence: PR 17676) | |
| Enumeration Date | 2009-08-05 |
| Last Update Date | 2023-07-19 |