| NPI | 1891962296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 233470) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VA 0101268643) |
| Enumeration Date | 2008-05-14 |
| Last Update Date | 2021-04-13 |