| NPI | 1003876657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: CA A31085) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA A31085) |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2010-06-17 |