| NPI | 1922360726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IA 44968) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R9361) |
| 207R00000X Internal Medicine (Licence: LA MD.207927) | |
| Enumeration Date | 2012-06-08 |
| Last Update Date | 2018-11-19 |