| NPI | 1356761118 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NC 2020-00285) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA 015650) |
| Enumeration Date | 2014-04-21 |
| Last Update Date | 2020-06-08 |