| NPI | 1386083343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX U0709) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD043966) |
| Enumeration Date | 2013-06-22 |
| Last Update Date | 2023-01-18 |