| NPI | 1710234158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME137338) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301101554) |
| Enumeration Date | 2012-08-03 |
| Last Update Date | 2019-08-30 |