| NPI | 1386165470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 1019807) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA ETLL-309) |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2024-10-31 |