| NPI | 1174507040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA A39353) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: GA 021731) |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2011-12-01 |