| NPI | 1700862885 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AZ 23616) |
| Additional Taxonomies | 163WC3500X Registered Nurse, Cardiac Rehabilitation (Licence: AZ 23616) |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2023-07-27 |