| NPI | 1457514440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 246727) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 236514) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2020-03-05 |