| NPI | 1770824948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL OS15966) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL OS15966) |
| 207R00000X Internal Medicine (Licence: MI 5101020439) | |
| Enumeration Date | 2013-03-12 |
| Last Update Date | 2019-08-29 |