| NPI | 1386058881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MT207420) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT207420) |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2023-03-19 |