| NPI | 1649436536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NM MD2010-0493) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0072028) |
| Enumeration Date | 2008-07-31 |
| Last Update Date | 2021-02-25 |