| NPI | 1770678179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME53968) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: FL ME0053968) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2024-06-10 |