| NPI | 1417162199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: FL ME116357) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT188559) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2022-06-30 |