| NPI | 1952782476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: MI 5101021940) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101021940) |
| Enumeration Date | 2015-06-10 |
| Last Update Date | 2022-07-12 |