| NPI | 1982181731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NH 24952) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 275468) |
| Enumeration Date | 2018-07-24 |
| Last Update Date | 2024-07-05 |