| NPI | 1750693248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX Q0216) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI AS3062508-8) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 123251) | |
| Enumeration Date | 2010-07-13 |
| Last Update Date | 2019-07-16 |