| NPI | 1528599222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AL 3616) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY R4613) |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2024-06-05 |