| NPI | 1568957561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: CO DR.0072776) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL52838) |
| Enumeration Date | 2018-06-22 |
| Last Update Date | 2024-07-24 |