| NPI | 1487653622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CO DR.0053203) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA G168646) |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2025-12-12 |