| NPI | 1871021279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: LA 322973) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL41087) |
| 207R00000X Internal Medicine (Licence: LA 322973) | |
| Enumeration Date | 2017-05-30 |
| Last Update Date | 2023-05-16 |