| NPI | 1477039147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: PA MT224839) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.073007) |
| Enumeration Date | 2018-07-16 |
| Last Update Date | 2022-04-27 |