| NPI | 1477783264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NV 15846) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM MD2013-0014) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA A137055) | |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2025-08-04 |