| NPI | 1952358376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AZ 56765) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NM MD2005-0713) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2022-02-03 |