| NPI | 1891180352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: GA 91531) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 007087) |
| Enumeration Date | 2015-04-01 |
| Last Update Date | 2022-08-23 |