| NPI | 1487147971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MO 2021013982) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2018012088) |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2021-08-20 |