| NPI | 1982958328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD471257) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI MD15409) |
| Enumeration Date | 2012-11-07 |
| Last Update Date | 2020-09-24 |