| NPI | 1700298189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME131285) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL 131285) |
| Enumeration Date | 2014-05-20 |
| Last Update Date | 2022-01-31 |