| NPI | 1962423327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME0054751) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME-0054751) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NC 2007-00323) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2020-12-21 |