| NPI | 1366890766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ R75743) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AZ 70958) |
| Enumeration Date | 2016-05-26 |
| Last Update Date | 2024-05-03 |