| NPI | 1962840744 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 266228) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 255147) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NH 20496) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: ME MD23506) | |
| Enumeration Date | 2013-06-13 |
| Last Update Date | 2020-07-21 |