| NPI | 1811363625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VA 0101275575) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101275575) |
| Enumeration Date | 2015-08-16 |
| Last Update Date | 2022-12-27 |