| NPI | 1801834833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: DE C1-0010164) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 22191) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2021-09-01 |