| NPI | 1134158074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX M3648) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD072363L) |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2015-11-04 |