| NPI | 1588652218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NC 35007) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 20426) |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2018-12-10 |