| NPI | 1629410774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD459734) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT205140) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA FM0998798) | |
| Enumeration Date | 2013-07-17 |
| Last Update Date | 2024-03-05 |