| NPI | 1275510356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD031413E) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD031413E) |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2015-08-12 |