| NPI | 1023175635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WY 3059A) |
| Additional Taxonomies | 174400000X Specialist (Licence: WY 3059A) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2016-12-22 |