| NPI | 1700970183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 202K00000X (Licence: NM 92-241) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NM 92241) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2022-07-21 |