| NPI | 1386608768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TN 48781) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 48781) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA A73259) | |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2023-03-02 |