| NPI | 1003841834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: HI 8690) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: CA G71314) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2012-12-26 |