| NPI | 1376520395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AZ 4529) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 4529) |
| 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: OH 34008390) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MT 26517) | |
| 207Q00000X Family Medicine (Licence: MT 26517) | |
| 207Q00000X Family Medicine (Licence: AK 6802) | |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2017-05-11 |