| NPI | 1538571195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AL 42967) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME136156) |
| Enumeration Date | 2014-05-29 |
| Last Update Date | 2021-10-11 |