| NPI | 1871805978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX Q7539) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 27600) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NE 6902) | |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2018-08-16 |