| NPI | 1801831805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MI 5101012252) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 6315144653) |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2023-06-21 |