| NPI | 1528043460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NV 18127) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY 33219) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MO 2010030195) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KS 04-34507) | |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2021-04-27 |