| NPI | 1881004810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: UT 12712005-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A141276) |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2022-08-28 |