| NPI | 1841491297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX P9776) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57011439) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NC 2013-02405) | |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2022-06-27 |