| NPI | 1932101789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: MI 4301086730) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: TN 35675) |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2021-09-16 |