| NPI | 1588675789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MN 17427) |
| Additional Taxonomies | 174400000X Specialist (Licence: MN 17427) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2020-10-16 |