| NPI | 1710270897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PR 18640) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 18640) |
| Enumeration Date | 2011-05-23 |
| Last Update Date | 2018-08-14 |