| NPI | 1750812822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IL 036.150296) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036.150296) |
| 207R00000X Internal Medicine (Licence: IL 125.070274) | |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2021-12-17 |