| NPI | 1861887663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: RI MD18350) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 273198) |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2022-06-15 |