| NPI | 1669677068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: UT 9661206-1204) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VA 0102202304) |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2019-06-13 |