| NPI | 1831487966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WY 11144A) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NE 33356) |
| Enumeration Date | 2011-07-11 |
| Last Update Date | 2021-02-17 |