| NPI | 1164587341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: RI 4283) |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: RI 4283) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2009-12-01 |