| NPI | 1821307877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS12464) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL UO2602) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL OS12464) | |
| Enumeration Date | 2010-09-24 |
| Last Update Date | 2025-04-04 |