| NPI | 1790096048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 56444) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MN 56444) |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2021-03-11 |