| NPI | 1932515558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: SC 83807) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 259799) |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2020-07-16 |