| NPI | 1932429719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MO 2018017509) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 51815) |
| Enumeration Date | 2010-06-03 |
| Last Update Date | 2020-09-01 |