| NPI | 1417230855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MT 60787) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: ME MD25659) |
| Enumeration Date | 2011-09-22 |
| Last Update Date | 2025-11-16 |