| NPI | 1790769685 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KS 04-38806) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA G63848) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WI 86360-20) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA MD00039797) | |
| Enumeration Date | 2005-12-04 |
| Last Update Date | 2025-10-09 |