| NPI | 1851493951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101263854) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME36915) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NM MD2010-0552) | |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2025-04-03 |