| NPI | 1902041296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MN 49688) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 49688) |
| Enumeration Date | 2008-12-16 |
| Last Update Date | 2020-11-10 |